High human immunodeficiency virus type 1 RNA load in the cerebrospinal fluid from patients with lymphocytic meningitis.
Thirty-seven matched cerebrospinal fluid (CSF) and plasma samples from 34 human immunodeficiency virus type 1 (HIV-1)-infected patients with suspected meningitis were analyzed for levels of HIV-1 RNA and markers of inflammation. Patients with tuberculous (n = 9) or cryptococcal (n = 6) meningitis had the highest CSF virus loads, which in many cases exceeded the levels in plasma, compared with patients with meningococcal meningitis (n = 3), aseptic meningitis (n = 8), tuberculoma (n = 2), or AIDS dementia complex (n = 4) or with normal lumbar punctures (n = 3). CSF virus load correlated significantly with the number of infiltrating lymphocytes (r = .60, P < .001) but not with plasma virus load, the levels of beta2-microglobulin in the CSF, or the integrity of the blood-brain barrier. These data suggest significant intrathecal HIV-1 replication in patients with lymphocytic meningeal infections such as tuberculous and cryptococcal meningitis.
Morris
L
L
National Institute for Virology, Department of Virology, University of the Witwatersrand, Johannesburg, South Africa. lmorris@adarc.org
Silber
E
E
Sonnenberg
P
P
Eintracht
S
S
Nyoka
S
S
Lyons
S F
SF
Saffer
D
D
Koornhof
H
H
Martin
D J
DJ
D015526:AIDS Dementia Complex / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology; D001812:Blood-Brain Barrier; D018791:CD4 Lymphocyte Count; D003453:Cryptococcosis / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology; D016655:HIV Core Protein p24 / Q000032:analysis; D015658:HIV Infections / Q000097:blood / Q000134:cerebrospinal fluid* / Q000276:immunology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes / Q000276:immunology; D008581:Meningitis / Q000097:blood / Q000134:cerebrospinal fluid* / Q000821:virology*; D008582:Meningitis, Aseptic / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology; D016921:Meningitis, Fungal / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology; D008585:Meningitis, Meningococcal / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology; D012367:RNA, Viral / Q000032:analysis / Q000302:isolation & purification*; D014390:Tuberculosis, Meningeal / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology; D019562:Viral Load; D001613:beta 2-Microglobulin / Q000032:analysis / Q000378:metabolism
D016655:HIV Core Protein p24; D012367:RNA, Viral; D001613:beta 2-Microglobulin